<img style="float: right;" src="https:\/\/opedge.com\/Content\/OldArticles\/images\/2004-02_10\/Fredrick-17.jpg" hspace="4" vspace="4" \/>\r\n\r\nOn April 14, 2002, Alvaro Uribe V\u00e9lez, then\r\npresident-elect of Colombia due to take office in one month,\r\ntravels to Barranquilla.\r\n\r\nBlanca Linda Rodriguez Charris, age 16, is finishing her\r\nafter-school job cleaning the small police station next to the\r\nbridge that leads to Barranquilla. She is in the sixth grade and is\r\nfortunate to be in school at all. She only started classes after\r\ntaking the job at the police station. It is the policeman who\r\ninsists she continue her education, and he makes it possible. Her\r\nhome is a mere ten meters (11 feet) beyond the bridge.\r\n\r\nA young policeman offers to walk Blanca home. As they prepare to\r\ncross the bridge, two small children--a seven-year-old boy and his\r\nfive-year-old sister--stop with their goat herd to see if he will\r\nbuy them a Coke. One by one, the animals dart into the police\r\nstation. Since Blanca has just cleaned it, the officer tells her to\r\nwait a moment and hurries back to chase the children and goats from\r\nthe building.\r\n\r\nBlanca notices a satchel on the edge of the bridge, but pays\r\nlittle attention. She waits patiently near the satchel as a bus\r\nwith cars behind it hurries toward her on the road. When the bus\r\npasses, a bomb in the satchel detonates. Another, hidden in a fish\r\npeddler's cart below the bridge, fortunately malfunctions.\r\n\r\nThe bus driver dies 22 days after the incident. Blanca receives\r\nmultiple fragmentation wounds and loses her leg above the knee. An\r\ninfant on the bus is also injured by shrapnel, and the police chief\r\nhas hearing loss and some mental complications.\r\n<h1>Blanca Found Near Death<\/h1>\r\n<table class="clsTableCaption" style="float: right; width: 64.4063%;">\r\n<tbody>\r\n<tr>\r\n<td style="width: 100%;"><img src="https:\/\/opedge.com\/Content\/OldArticles\/images\/2004-02_10\/Fredrick-16.jpg" alt="Debbie Plescia, CPO, and patient following Blanca's first prosthetic consult." \/><\/td>\r\n<\/tr>\r\n<tr>\r\n<td style="width: 100%;">Debbie Plescia, CPO, and patient following Blanca's first prosthetic consult.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nBlanca's mother, Luz Elvia Charris, feels an\r\nincredible rumble as the concussion hits her small home. Roof tiles\r\nfly off houses near the bridge. Mrs. Charris stumbles outside and\r\nsees a car struggle by with all four tires on fire. She doesn't\r\nrealize it belongs to the president-elect. Down the road,\r\nV\u00e9lez is hurried out of the mangled vehicle into another that\r\nspeeds away.\r\n\r\nDazed, Mrs. Charris moves toward the bridge. Debris is\r\neverywhere. Her neighbor is lying in the door of her house, and\r\nMrs. Charris stops to help. The lady is badly wounded, but sits up,\r\nand Mrs. Charris hurries on, seeking her daughter. She crosses the\r\nbridge, passing a mangled body. Arriving at the police station, she\r\nsuddenly realizes the body is wearing her daughter's school dress.\r\nShe returns to find Blanca near death.\r\n\r\nI learn all this as Debbie Plescia, CPO, prepares to cast Blanca\r\nfor an AK prosthesis. In Colombian hospitals, families--not\r\nhospital staff--provide food and care. Mrs. Charris stays by\r\nBlanca's bed day and night. In her absence, Blanca's younger\r\nsister, now 14, is taken advantage of by a boyfriend. She watches\r\nPlescia with a big smile as she holds her newborn son.\r\n\r\nOnce V\u00e9lez took office, he replaced the Charris' home and\r\nothers destroyed in the blast. Blanca healed well, but is deeply\r\nscarred physically and emotionally. The opportunity to make her\r\nfirst prosthesis is a privilege from a personal perspective, as\r\nwell as a contribution to Colombia's president.\r\n<h1>More Needed than O&P Care<\/h1>\r\nThe case is a vivid example of one of the critical differences\r\nin rehabilitation between developed and undeveloped nations. Once\r\nBlanca is successfully fitted with her prosthesis, we will do our\r\nbest to insure she continues her education. Such sociological\r\naspects of the patient's personal life are seldom directly targeted\r\nby rehabilitation practitioners in the US. Here, they are a\r\nnecessary ingredient to full recovery. Once we intervene, if we\r\nchoose to really change the lives of our patients, our\r\nresponsibility spreads like oil on water. In setting such an\r\nexample to local practitioners on all levels of the clinical team,\r\nthe goal is to plant seeds of change beyond Blanca's prosthesis or\r\nthe new house purchased by the president.\r\n\r\nMy scheduled duties on the trip conclude at an interview with a\r\nlocal representative of ACNUR, the UN Office of the High\r\nCommissioner for Refugees. When we attempt to leave the building,\r\nthe rains have come turning streets into rivers. We are told that\r\nduring recent similar rains, the houses of 20 poor people were\r\ndestroyed. Although foot bridges were quickly constructed to allow\r\nthe poor to pass safely, they must pay to use them.\r\n\r\nThe poor pay for what the rich accept as expected conveniences,\r\nat least in this part of the world. What remains for us to\r\ndetermine (hopefully with the aid of a USAID grant), is how to make\r\na few of life's "expected" or humanitarian conveniences available\r\nto at least some of Barranquilla's refugees and displaced\r\nresidents. Nowhere does skill in O&P means as much as it does\r\nin an environment like this. It is just the start, the seed of a\r\nprocess that might open the door into a better world--for some,\r\nanyway. And, not to be overlooked, it presents an opportunity to\r\ngive away some of the abundance that we have so carelessly grown\r\naccustomed to in the US.